PROFESSIONAL INDEMNITY MEDICAL MALPRACTICE PUBLIC AND PRODUCTS LIABILITY FOR HEALTHCARE PRACTITIONERS

Transcription

1 PROFESSIONAL INDEMNITY MEDICAL MALPRACTICE PUBLIC AND PRODUCTS LIABILITY FOR HEALTHCARE PRACTITIONERS This is to certify that in accordance with the authorisation granted to The Hollard Insurance Company Limited (The Underwriters ) (Reg. No.1952/003004/06 and FSP no ) and in consideration of, and conditional upon, the prior payment of the Premium by or on behalf of the Insured and receipt thereof by or on behalf of the Insurers, the Insurers are hereby bound to insure in accordance with the terms, Exclusions, Conditions and limitations contained herein or endorsed hereon. The Policy and its Schedule and Endorsements shall be read together as one contract. It is conditional upon and will only come into effect following payment of the Premium by the Insured and the receipt thereof by or on behalf of the Insurers. Any word or expression to which a specific meaning or Definition has been given shall have such specific meaning wherever it may appear. Page 1 of 17 CFP & Hollard Scheme Medical Practitioner Wording 2015

2 1. PREAMBLE The Insured having made a written proposal to Insurers and/or otherwise submitted particulars and statements constituting an acceptable risk profile, which proposal and/or risk profile shall form the basis of this insurance, the Insurers will indemnify the Insured in accordance with the Schedule, policy terms, Exclusions, Conditions and limitations contained herein or endorsed hereon. In consideration of this and subject to all the provisions of this policy, the Insurer agrees as follows: 2. DEFINITIONS For the purpose of determining the indemnity granted: 2.1 Business shall mean the business identified in the Schedule and conducted within the Territorial Limits. 2.2 Breach of Duty shall mean any actual or alleged negligent act, error, omission, misstatement, misleading statement, breach of confidentiality or omission in the performance of or failure to perform Professional Services. 2.3 Claim shall mean any: (i) written demand or (ii) civil or administrative proceeding that seeks Damages as a result of Wrongful Acts, or (iii) Regulatory or Statutory Body complaint, such as HPCSA or SANC but not limited thereto and subject to clause 6.4 of Defence Costs. 2.4 Damages shall mean any amount that an Insured shall be legally liable to pay to a Third Party in respect of judgments rendered against an Insured or for settlements which conform with the consent requirements set out the Conditions of this policy and subject to the limitations of Loss 2.5 Deductible shall mean the first amount of each and every Claim to be borne by the Insured. The Deductible shall apply per Claim or series of claims arising from one originating cause or source. For the avoidance of doubt the Deductible is payable by the Insured towards Damages and Defence Costs upon the request of the Insurer. It is payable regardless of the outcome of the Claim. 2.6 Defence Costs shall mean all costs and expenses incurred by the Insurers on behalf of the Insured or by the Insured with Insurers prior written consent in connection with any claim which forms the subject of indemnity under this Policy. Defence Costs shall not mean any internal or overhead expenses of any Insured or cost of any Insured s time. 2.7 Environmental Impairment / Pollution shall mean the emission, discharge, release, dispersal, disposal, seepage or escape of solid, liquid, gaseous or thermal contaminants or irritants, including vapours, smell, odours, humidity, fumes; smoke, soot or other airborne particulates; acids, alkalis, chemicals and waste; electromagnetic waves, noise, vibrations; other emission of effluent or noxious substances into or upon the soil, the atmosphere or Page 2 of 17 CFP & Hollard Scheme Medical Practitioner Wording 2015

3 any watercourse or body of water which changes the natural state or condition of the soil, the atmosphere or any watercourse or body of water other than by a sudden, accidental and identifiable event; the depositing or storing of effluent, noxious substances, nuclear material or nuclear waste and the breach of any legislation relating to the aforegoing. 2.8 Good Samaritan Act shall mean treatment administered at the scene of a medical emergency, accident or disaster by the Insured who is present either by chance, or in response to a general call following a disaster. It is accepted by Insurers that such treatment may fall outside the normal scope of practice of the Insured and Insurers will nevertheless indemnify the Insured for Good Samaritan Acts. 2.9 Insured shall mean: a) The Insured reflected on the policy schedule and all paid-up members of the Society/Association, b) any present or former employee, locum, director or officer of the Insured in respect of those activities that are conducted within the course and scope of the Business of the Insured, c) any predecessors of the Insured but only to the extent that liability attaches to the Insured, d) any partnership, closed corporation or incorporated company that the Insured is a partner, member or director of, provided that in the event that any of the partners or directors are not Insured through this Professional Indemnity, Medical Malpractice and Liability Scheme ( the Scheme ) with Hollard at the time of the incident, then Insurers will only be responsible for that portion of the claim, calculated pro-rata, in the same proportion that the partners or directors Insured through the Scheme with Hollard bear to the total number of partners, members or directors in that partnership, closed corporation or incorporated company at the time that the incident occurred. This pro-rata calculation will include previous directors, members or partners who were insured through the Scheme with Hollard at the time that the incident occurred. Insurers liability in respect of any claims against a partnership, closed corporation or incorporated company will be limited to R50 Million or the cumulative total of all individual limits of indemnity in respect of the partners or directors whichever is the lesser. e) in the event of the death, incapacity, insolvency or bankruptcy of any person treated as the Insured (in respect of claims against such person) his estate, legal representatives and/or heirs Insurer shall mean the entity specified as such in the Schedule 2.11 Limit of Indemnity shall mean the amount specified as such in the Schedule 2.12 Loss shall mean Damages and Defence Costs. Loss shall not mean and this policy shall not cover any (1) taxes (excluding the indemnity provided for VAT as provided for above in section 9.2), (2) non-compensatory damages, including punitive, multiple, exemplary or liquidated damages, (3) fines or penalties, (4) the costs and expenses of complying with any order for, grant of or agreement to provide injunctive or other Page 3 of 17 CFP & Hollard Scheme Medical Practitioner Wording 2015

4 non-monetary relief, (5) compensation, benefits or overhead of, or charges or expenses by any Insured, or (6) any matters which may be deemed uninsurable under the law governing this policy or the jurisdiction in which a Claim is brought North America shall mean the United States of America (being the fifty states of the union plus the District of Columbia), Canada and any territory operating under the laws of or subject to the jurisdiction of courts of the afore-mentioned territories Malpractice shall mean any negligent act, error or omission in the Professional Duties Patient shall mean any person undergoing treatment by the Insured in the course of the Business Period of Insurance shall mean the period of time specified in the Schedule unless the policy is cancelled in which event the Period of Insurance will end of the effective date of cancellation Professional Duties shall mean the activities and duties which would fall within the normal scope of duties and services performed by a professionally qualified paid-up member properly registered in terms of the current applicable Act/s that governs such profession and field of business, as stated in the Schedule Product shall mean any property in or after it has left the custody or control of the Insured which has been labelled, prescribed, designed, specified, formulated, manufactured, constructed, installed, sold, supplied, distributed, treated, serviced, altered or repaired by or on behalf of the Insured, but shall not mean food and drink supplied by or on behalf of the Insured primarily to the Insured s employees as a staff benefit ( Food and Drink ) Retroactive Date shall mean the date that the Society/Association provides for each individual paidup member when they first became a paid-up member of the Society/Association, provided there has been no break in the membership since that date Society/Association shall mean the statutory body consisting of paid-up Insured members Territorial Limits shall be Worldwide excluding North America Third Party shall mean any entity or natural person, provided, however, Third Party does not mean (i) any Insured, save for provisions contained in Cross Liabilities clause 8.5; or (ii) any other entity or natural person having a financial interest or executive role in the operation of the Insured s Business 2.23 Vehicle shall mean any land Vehicle or trailer (including any machinery or apparatus attached thereto) whether or not subject to Vehicle regulation and whether or not self-propelled. Page 4 of 17 CFP & Hollard Scheme Medical Practitioner Wording 2015

5 2.24 Wrongful Acts shall mean any Breach of Duty, Defamation and Fraud/Dishonesty 3. INSURING CLAUSES The indemnity granted by this Policy solely applies to all Claims first made against the Insured during the Period of Insurance and reported to the Insurer as required by this policy and in respect of which the Insured shall become legally liable to pay compensation, including claimants' costs fees and expenses and Defence Costs arising out of and in the course of the Business conducted within the Territorial Limits and as set out in Sections One, Two, Three and Four hereof. This shall be in accordance with the law of any country but not in respect of any judgment, award, payment or settlement made within countries which operate under the laws of North America (or to any order made anywhere in the world to enforce such judgment, award or settlement either in whole or in part). 4. SECTION ONE PROFESSIONAL INDEMNITY 4.1 INDEMNITY 4.2 EXTENSION The Insurers will indemnify the Insured under this section against their legal liability to pay compensation (including claimants costs, fees and expenses) as a result from any Claim for any actual or alleged negligent act, error or omission by the Insured in the course of the Business other than as provided for in Section Two Malpractice LIABILITY FOLLOWING EMPLOYEE/VOLUNTEER DISHONESTY 4.3 EXCLUSION This policy extends to cover Claims arising out of any dishonest, fraudulent or malicious act or omission of any employee or volunteer (not being a director, partner or principal) of the Insured The Insurers shall not be liable to indemnify the Insured in respect of Claims arising from breach of contract unless such breach is a breach or alleged breach of Professional Duty by the Insured or any other person upon whom the Insured has placed reliance. 5. SECTION TWO MALPRACTICE 5.1 INDEMNITY The Insurers will indemnify the Insured under this Section against Claims for and/or arising out of death of, bodily or mental injury to and/or illness or disease sustained by any Patient caused or alleged to have been caused by Malpractice or a Good Samaritan Act. The indemnity extends to any Emergency Medical Conveyance owned or used by the Insured in connection therewith. Page 5 of 17 CFP & Hollard Scheme Medical Practitioner Wording 2015

6 5.2 EXCLUSION This indemnity extends to any failure to diagnose a condition, delayed diagnosis or any mis-diagnosis of a condition which results in a claim or a complaint against the Insured. This section does not cover liability for claims arising out of or in connection with any Product, but this Exclusion shall not apply to claims arising out of the incorrect prescription or use of such Products. 6 SECTION THREE - DEFENCE COSTS 6. 1 The Insured shall render at their own cost all such assistance as the Insurers may require in order to investigate defend or settle any claim and shall arrange to be available at their own cost for such interviews as may be required by the Insurers or any advisers or legal representatives appointed by the Insurers The Insurers will pay any expenses incurred by the Insured (excluding such costs mentioned in 6.1) in order to assist with the investigation defence or settlement of any claim made against the Insured and the costs of representation at any inquest, inquiry or other proceedings in respect of matters which have a direct relevance to any Claim made or which might be made against the Insured, provided such Claim or Claims are the subject of indemnity by this policy and the Insurers prior written consent is obtained. 6.3 All costs, fees and expenses incurred by the Insurers or at their instance in the investigation defence or settlement of any claim made against the Insured and the costs of representation at any inquest, inquiry or other proceedings in respect of matters which have a direct relevance to any Claim made or which might be made against the Insured shall be deemed to be costs, fees and expenses incurred by the Insured with the prior consent of the Insurers. 6.4 Notwithstanding 6.2 and 6.3 above, the Insurers will in addition pay all fees for representation or defence of the Insured with the Insurer s written consent at an inquest or disciplinary committee of the Health Professions Council or any other Statutory Body governing the conduct of the Insured s Business, regardless of the nature of the complaint and whether or not it could result in a civil or other Claim against the Insured which is covered under this policy. 7. SECTION FOUR- PUBLIC LIABILITY 7.1 INDEMNITY The Insurers will indemnify the Insured under this Section against their legal liability for claims arising out of: a) accidental death, bodily and mental injury, illness or disease of or to any person; b) accidental loss of possession or control of or actual damage to property; arising out of and in the course of the Business. Page 6 of 17 CFP & Hollard Scheme Medical Practitioner Wording 2015

7 7.2 EXTENSION 7.3 EXCLUSIONS PRODUCTS AND DEFECTIVE WORKMANSHIP LIABILITY The Insurer will indemnify the Insured for any Claim first made against the Insured and notified to the Insurer during the Period of Insurance which is alleged to have been caused by a product. This extension extends to include claims arising out of defective workmanship, defective packaging and labelling. Claims for inadequate or incorrect instructions with regard to the use of the product will be covered under the medical malpractice section of this policy. This extension shall be subject to the following exclusions: 1. Efficacy Claims arising out of the failure of a Product, or any part thereof, to fulfil the purpose for which it was intended, or to perform as specified, warranted, or guaranteed; but this Exception shall not apply to consequent Bodily Injury or loss of, or damage to, Property. 2. Recall Claims arising out of recalling, removing, repairing, replacing, reinstating, or the cost of, or reduction in value of, any Product, if such liability arises from any defect therein or the harmful nature or unsuitability thereof. This Section does not cover liability for Claims arising out of: a) the ownership, possession or use by or on behalf of the Insured of any motor vehicle or trailer for which compulsory insurance is required by legislation, other than claims : i) caused by the use of any tool or plant forming part of or attached to or used in connection with any motor vehicle or trailer; ii) iii) arising beyond the limits of any carriageway or thoroughfare caused by the loading or unloading of any motor vehicle or trailer; arising out of any motor vehicle or trailer temporarily in the Insured's custody or control for the purpose of parking; b) liability for which compulsory insurance is required by legislation governing the use of any motor vehicle or trailer; c) the ownership, possession or use by or on behalf of the Insured of any aircraft, watercraft or hovercraft; d) damage to property owned, leased or hired or under hire purchase or on loan to the Insured or otherwise in the Insured's care custody or control other than: i) premises (or the contents thereof) temporarily occupied by the Insured for work therein, or other property temporarily in the Insured's possession for work thereon (but no indemnity is granted for damage to Page 7 of 17 CFP & Hollard Scheme Medical Practitioner Wording 2015

8 that part of the property on which the Insured is working and which arises out of such work); ii) iii) employees' and visitors' clothing and personal effects; premises tenanted by the Insured, but only to the extent that the Insured would be held liable in the absence of any specific agreement; e) Environmental Impairment / Pollution unless such Environmental Impairment / Pollution was the direct result of a sudden, specific and identifiable event occurring during the Period of Insurance and did not arise as a result of the Insured s failure to take reasonable precautions; f) or in connection with any Product, subject to provisions in above. 8 EXTENSIONS The following Extensions shall apply automatically under all sections of cover under this policy and: a) shall be subject to the relevant Indemnity, Limits and Excesses stated in the Schedule to apply to the Extensions; b) are subject otherwise to the terms, Exclusions, Conditions and limitations of the Policy; PROVIDED ALWAYS THAT the total liability of the Insurers is not increased beyond that which would have applied in the absence of such Extensions STATUTORY AND CRIMINAL DEFENCE COSTS Notwithstanding anything to the contrary contained in this Policy, the Insurers will indemnify the Insured in respect of legal and Defence Costs with the consent of the Insurers in the defence of any criminal action or criminal prosecution brought against the paid-up member or Insured arising from actual or alleged breach of any Statutes governing the conduct of the Insured s Business. This cover shall extend to include legal costs and Defence Costs incurred with the consent of the Insurers in the defence of any criminal action or charge made against the Insured during the Period of Insurance as a result of the alleged contravention of any Statute governing the conduct of the business (other than Statutes governing the ownership or use of motor vehicles, the Labour Relations Act No.66 of 1995 or the Companies Act No. 71 of 2008 ) and as read in conjunction with the Criminal Procedure Act No. 56 of 1955, or as amended from time to time. PROVIDED ALWAYS THAT : a) no indemnity shall be granted for fines or penalties; b) in the case of an Appeal, the Insurers shall not indemnify the Insured unless its legal representatives (chosen by the Insurer in its sole discretion) shall advise that such Appeal should be likely to succeed. c) No indemnity is provided in respect of any costs and expenses other than the legal costs and Defence Costs referred to in this section. Page 8 of 17 CFP & Hollard Scheme Medical Practitioner Wording 2015

9 8.2. WRONGFUL ARREST Notwithstanding anything to the contrary in this Section, the Insurers will indemnify the Insured in respect of claims arising out of Wrongful Arrest (as hereinafter defined) committed or alleged (other than by the Insured) to have been committed by the Insured in the course of the Business PROVIDED ALWAYS THAT : a) for the purposes of this Extension, the terms Wrongful Arrest shall mean : i) assault and battery committed or alleged to have been committed at the time of making or attempting to make an arrest or in resisting an overt attempt to escape by a person under arrest before such person has been or could be placed in the custody of the police or a law enforcement officer; ii) iii) defamation, injuria, false imprisonment or malicious prosecution either committed or alleged to have been committed directly in connection with an arrest or arising out of the investigation of acts of shoplifting or theft; wrongful discharge of any employee. b) no indemnity shall be granted in respect of claims : i) made against the Insured by any person or persons other than those being or having been or alleged have been arrested or under arrest, or their personal representatives; ii) iii) made against the Insured by any Director, Partner or employee of the Insured, or their personal representatives; arising out of unfair labour practice as within the meaning of the Labour Relations Act No.66 of 1995; c) the total liability of the Insurers under this Extension shall not exceed the Indemnity Limit in respect of all claims made against the Insured during the Period of Insurance EMPLOYERS LIABILITY Notwithstanding anything to the contrary contained in General Exclusion 10.a)3), the indemnity granted by this Section extends to include claims arising out of Injury to any person employed under a contract of service or apprenticeship with the Insured where such Injury arises out of and in the course of the execution of such contract. PROVIDED ALWAYS THAT : No cover is provided for : a) liability for claims arising from illness or disease, or contributed to by prolonged exposure to substances, factors or circumstances, peculiar to any particular employment or occupation; Page 9 of 17 CFP & Hollard Scheme Medical Practitioner Wording 2015

10 b) liability for claims arising out of asbestos or asbestos related disease of the respiratory system, but this exclusion shall not apply to claims where the proximate or contributory cause is not related to asbestos dust or fibres; c) amounts recoverable under any Workmen s Compensation Enactment applicable from time to time INDEMNITY TO OTHERS The indemnity granted by this policy extends to: a) any party who enters into an agreement with the Insured for any purpose of the Business, but only to the extent required by such agreement to grant such indemnity and subject always to Section Four Exclusion 7.3 (d) (iii) and General Exclusion 10(a)5; b) officials of the Insured in their business capacity arising out of the performance of the Business or in their private capacity arising out of their temporary engagement of the Insured's employees; c) the officers, committee and members of the Insured's canteen, social, sports, medical, fire fighting and welfare organisations in their respective capacities as such; d) the personal representatives of the estate of any person who would otherwise be indemnified by this Policy, but only in respect of liability incurred by such person. Provided always that such persons or parties shall observe, fulfil, and be subject to the terms, Exclusions, Conditions and limitations of this Policy as though they were the Insured. 8.5 CROSS LIABILITIES 9. LIMIT OF INDEMNITY Each Insured indemnified is separately indemnified in respect of claims made against any of them by any other, subject to the total liability of the Insurers not exceeding the stated Indemnity Limit. 9.1 The total liability of the Insurers, in terms of the Insuring Clause: a) Per Claim or series of claims arising from one originating cause or source, including interest thereon, all claimants costs, fees and expenses and Defence Costs; b) in respect of all claims per Period of Insurance; shall not exceed the Limit of Indemnity stated in the Schedule. 9.2 Where applicable, the Insurers will indemnify the Insured for any Value Added Tax (VAT) obligation that may be incurred subject to and inclusive in the Limit of Indemnity. Page 10 of 17 CFP & Hollard Scheme Medical Practitioner Wording 2015

11 10 (a) GENERAL EXCLUSIONS APPLICABLE TO ALL SECTIONS This Policy does not cover liability: 1 a) arising from circumstances which may reasonably be expected to give rise to a Claim known to the Insured at the inception or renewal date of this Policy, b) arising from any circumstances notified to the Insurers of any other policy prior to the inception date hereof; 2 relating to any negligent act, error or omission which was or may have been or is alleged to have been committed or omitted (as the case may be) before the Retroactive Date; 3 for any death, bodily or mental injury, disease or illness to any person employed by the Insured under a contract of service or apprenticeship or training which arises out of or in the course of such employment, subject to the Employer Liabilities clause 8.3; 4 for the costs of replacing or restoring any of the Insured s documents; 5 arising out of liquidated damages clauses, penalty clauses or performance warranties except to the extent that it can be proved that liability would have attached in the absence of such clauses or warranties; 6 arising out of any dishonest, criminal or malicious act or omission, or any act or omission in violation of any law or ordinance, committed by or on behalf of the Insured, save where such criminal or illegal conduct is negligent and not reckless or intentional; 7 If at the time of any event giving rise to a Claim under this policy, other insurance cover exists applicable to such Claim, the Insurer shall be liable (subject at all times to the terms of this policy) to pay only a rateable proportion of the amount payable to the Insured in respect of such Claim, whether the Insured is paid under such other insurance or not. If such other insurance is provided by the Insurer or any group company or affiliate of Hollard Insurance Company Ltd, ("Hollard"), then the maximum amount payable by Hollard under all such policies shall not exceed the Limit of Indemnity of that policy referred to above which has the highest applicable Limit of Indemnity. Nothing contained herein shall be construed to increase the Limit of Indemnity of this policy. To the extent that another insurance policy imposes upon an insurer a duty to defend a Claim, Defence Costs arising out of such Claim shall not be covered under this policy. 8 for contractual liability/performance guarantees arising out of, based upon, or attributable to any; i) contractual liability or other obligation assumed, that goes beyond the duty to use such skill and care as is ordinarily applied to the Professional Duties provided; ii) iii) performance guarantee or warranty delay in performing, failing to perform or failing to complete any Professional Duties, unless such delay or failure arises from Breach of Duty by the Insured; 9 arising out of employment practices, based upon any actual or alleged employmentrelated practices or labour disputes; Page 11 of 17 CFP & Hollard Scheme Medical Practitioner Wording 2015

12 10 arising out of, based upon or attributable to any act which a court, judge, arbitrator or statutory body finds or which an Insured admits, to a criminal or illegal conduct, dishonest or fraudulent act, and in such event, the Insurer shall be reimbursed for all Loss paid (including any VAT indemnification) in connection with such Claim; 11 for and/or arising out of : a) any award or damages granted in terms of a judgment delivered or obtained in the first instance; b) costs, fees and/or expenses of litigation incurred; c) the conduct of the Business; in North America; 12 up to the amount of the Deductible; 13 for fines, penalties, punitive, vindictive or exemplary damages; 14 arising from the performance of the activities of the Insured whilst under the influence of intoxicants or narcotics excluding medication prescribed and/or administered by a properly qualified doctor as well as any over the counter drugs which are being taken at the time for recognised medical complaints or conditions. 15 arising out of loss of or distortion of computer data due to: a) the presence of magnetic flux; b) defects in the data tapes or other data media; c) use or processing whilst mounted in or on any machine; d) wear, tear, vermin or gradual deterioration; e) climatic or atmospheric conditions or extremes of temperature; 16 arising out of : a) loss of money (including, but not limited to postal and money orders and Kruger Rands); b) theft or forgery; 17 arising out of the insolvency of the Insured; 18 arising out any medical and biological research as well as medical and/or clinical trials 19 arising out of any clinical trials 20 arising out of any loss, damage, cost or expense directly or indirectly arising out of, contributed to by, or resulting from any infectious epidemic/pandemic (if classified either way by the appropriate national or international body/agency) which leads to: (i) (ii) the imposition of quarantine or restriction in movement of people or animals by the national or international body or agency; and/or any travel advisory or warning being issued by a national or international body or agency and in respect of (i) or (ii) any fear or threat thereof (whether actual or perceived). 21 arising out of any condition directly or indirectly caused by or associated with Human Immune Virus HIV or mutant derivatives or variations thereof or in any way related to Acquired Immune Deficiency Syndrome AIDS or any syndrome or condition of a similar kind howsoever it may be named. This also applies to contraction of AIDS by needle stick injuries, blood transfusions or any other method of transfer. However this exclusion will not apply to any liability relating to the claimant s status in regard to Page 12 of 17 CFP & Hollard Scheme Medical Practitioner Wording 2015

13 HIV/AIDS or any similar condition. 22 Arising out of cyber liability. However, should this exclusion be applicable to Special Extension 12.3, cover for Damages and Defence Costs will be afforded to be 10% of Sum Insured subject to the applicable Deductible; 23 arising out of decennial liability; 24 as a result of failure to effect or maintain insurance; 25 arising out of: a) any Environmental Impairment / Pollution occurring during the Period of Insurance. b) any contravention of Pollution and / or Environmental Laws. c) delays in projects requiring official regulatory Environmental approval. 26 arising out of any advice given on North American Law 10(b) COMPUTER VIRUS EXCLUSION Notwithstanding any provision of this Policy including any special Exclusion or extension or other provision not included herein which would otherwise override a general Exclusion, this Policy does not cover any legal liability of whatsoever nature directly or indirectly caused by or contributed to by or consisting of or arising from the incapacity or failure of any computer, correctly or at all, to capture, save, retain or to process any data as a result of the action of any computer virus, or other corrupting, harmful or otherwise unauthorised code or instruction including any trojan horse, time or logic bomb or worm or any other destructive code, media or programme or interference. A computer includes any computer, data processing equipment, microchip, integrated circuit or similar device in computer or non-computer equipment or any computer software, tools, operating system or any computer hardware or peripherals and the information or data electronically or otherwise stored in or on any of the above, whether the property of the Insured or not. 10(c) WAR / TERRORISM EXCLUSION The Insurers shall not be liable to indemnify the Insured in respect of claims directly or indirectly caused by, resulting from happening through or in connection with: a) war, invasion, act of foreign enemy, hostilities or warlike operations (whether war be declared or not), civil war, mutiny, insurrection, rebellion, revolution, military or usurped power; b) any action taken in controlling, preventing, suppressing or in any way relating to the excluded situations in a) above, including, but not limited to, confiscation, nationalization, damage to or destruction of property by or under the control of any Government or Public or Local Authority; c) any act of terrorism regardless of any other cause contributing concurrently or in any other sequence to the loss. For the purpose of this Exclusion, terrorism means an act of violence or any act dangerous to human life, tangible or intangible property or infrastructure with the intention or effect to influence any government or to put the public or any section of the public in fear. In any action suit or other proceedings where the Insurer alleges that by reason of this Exclusion a loss is not covered by this insurance the burden of proving that such loss is covered shall be upon the Insured. Page 13 of 17 CFP & Hollard Scheme Medical Practitioner Wording 2015

14 10(d) NUCLEAR EXCLUSION This Policy does not cover any legal liability, loss, damage, cost or expense whatsoever or any consequential loss directly or indirectly caused by or contributed to by or arising from: (i) (ii) (iii) (iv) ionising, radiations or contamination by radio-activity from any nuclear fuel or from any nuclear waste from the combustion or use of nuclear fuel; nuclear material, nuclear fission or fusion, nuclear radiation; nuclear explosives or any nuclear weapon; nuclear waste in whatever form; regardless of any other cause or event contributing concurrently or in any other sequence to the loss. For the purpose of this Exclusion only, combustion shall include any self-sustaining process of nuclear fission. 10(e) ASBESTOS EXCLUSION Notwithstanding any provision of this Policy including any Exclusion, exception or extension or other provision which would otherwise override an Exclusion, this Policy does not cover any legal liability, loss, damage, cost or expense whatsoever or any consequential loss directly or indirectly caused by, arising out of, resulting from, in consequence of, in any way involving, or to the extent contributed to by, the hazardous nature of asbestos in whatever form or quantity. 11. GENERAL CONDITIONS Conditions 11.1 to 11.7 are Conditions precedent to the liability of the Insurers to provide indemnity under this Policy Premium is payable on or before the inception date or renewal date or instalment date as the case may be. The Insurer shall not be obliged to accept premium tendered to them more than 15 days after such date but may do so upon such terms as they in their sole discretion may determine The Insured shall give written notice to the Insurers as soon as practicable of any claim made against the Insured (or of any specific event or circumstance which may give rise to a claim being made against the Insured) and which forms the subject of indemnity under this Policy and shall give all such additional information as the Insurers require. Every claim, writ, summons or process and all documents relating to the Claim, event or circumstance shall be forwarded to the Insurers immediately they are received by the Insured. If the Insured notifies the Insurers during the Period of Insurance of any event or circumstance which the Insurers accept may give rise to a claim being made against the Insured, then such claim shall for the purpose of this Policy be treated as having been first made against the Insured during the Period of Insurance. This policy will allow the Insured the opportunity to notify Insurers of claims made against them or circumstances that may give rise to claims being made against them as soon as practicable but not later than 30 days after expiry of this insurance provided that the Insured first became aware of the claim or circumstance prior to expiry The Insured shall maintain accurate descriptive records of all professional duties rendered for the period required/stipulated by legislation/regulation and/or guidelines provided by the Insured s Statutory Body, which records shall be made Page 14 of 17 CFP & Hollard Scheme Medical Practitioner Wording 2015

15 available for inspection and use by the Insurers or their duly appointed representatives insofar as they pertain to any claim under this Policy No admission, offer, promise or payment shall be made or given by or on behalf of the Insured without the written consent of the Insurers who shall be entitled if they so desire to take over and conduct the defence or settlement of any claim or to prosecute in the name of the Insured any claim for indemnity or damages or otherwise and shall have full discretion in the conduct of any proceedings and in the settlement of any claim and the Insured shall give all such information and assistance without charge as the Insurers require Whilst this insurance shall remain fully operative in the event of a change in the constitution of the Insured, notice shall be given as soon as reasonably possible of any change in the Principals, Partners, Members or Directors or in the legal constitution of the Insured and the Insured shall supply such further information as the Insurers may require for reassessment of the risk The interpretation and enforcement of the terms, Conditions and Exclusions of this Policy (and any phrase or word contained herein) shall be in accordance with the law of the Republic of South Africa whose courts shall have jurisdiction to the exclusion of the courts of any other country The Policy and the Schedule shall be read together as one contract and any word or expression to which a specific meaning has been attached in any part of this Policy or Schedule shall bear such specific meaning wherever it may appear The Insurers may at any time pay to the Insured in connection with any claim or series of claims under this Policy to which the Limit of Indemnity applies the amount of such limit (after deduction of any amounts already paid) or any lesser amount for which such claim or claims can be settled and upon such payment being made the Insurers shall relinquish the conduct and control of and be under no further liability in connection with such claim or claims notwithstanding the fact that the Insured has been only partially reimbursed for their loss due to the amount of any Deductible payable in terms hereof Where this Policy has been extended to include dishonest acts or omissions of any person treated as the Insured, in respect of claims arising from such dishonesty, the Insured shall assist Insurers to take all possible action to sue for and obtain reimbursement from such person and any money or other property held by the Insured which, but for such dishonesty, would be due to such person shall, to the extent allowable in law, be deducted from the Insured s loss All recoveries made in respect of any claim under this Policy shall be applied (after deduction of the costs, fees and expenses incurred in obtaining such recovery) in the following order of priority: a) the Insured shall first be reimbursed for the amount by which their liability in respect of such claim exceeded the amount of indemnity provided by the Policy; b) the Insurers shall then be reimbursed for the amount of their liability under the Policy in respect of such claim; c) any remaining amount shall be applied towards the amount of the Deductible borne by the Insured in respect of such claim. Page 15 of 17 CFP & Hollard Scheme Medical Practitioner Wording 2015

16 11.11 Where the Premium is provisionally based on the Insured's estimates, the Insured shall keep accurate records and declare and make payment for all additional and late-joining members on at the least a quarterly basis if not more frequently If indemnity is sought under this Policy by any fraudulent means : a) all benefit in respect of such claim shall be forfeited; b) Insurers may cancel the Policy with immediate effect by notice in writing to the last known address of the Insured If the Limit of Indemnity is increased during the Period of Insurance, the liability of the Insurers in respect of claims made against the Insured or for circumstances notified, or which should have been notified, to the Insurers prior to such increase, shall not exceed the Limit of Indemnity applicable prior to such increase Whenever this Policy provides notice to be given to the Insurers via the Insured Broker such notice shall be given to : CFP BROKERS CC Sweet Thorn on Beyers Block C, Ground Floor 61 Bosbok Road P.O. BOX 1964 Randpark Ridge BROMHOF South Africa Telephone: (011) / / Facsimile: noleen@cfpbrokers.co.za or kristy@cfpbrokers.co.za PROOF OF MEMBERSHIP In the event of a claim, the Association/Society will provide proof that the member is a paid-up member of such Association/Society. This will not apply where the Insured is acting in their official capacity or volunteers for the Association/Society. 12. SPECIAL EXTENSIONS The following Extensions: a) apply, provide always that the total liability of the Insurers is not increased beyond that which would have applied in the absence of such Extensions; b) are subject otherwise to the terms, Exclusions, Conditions and limitations of the Policy ADDITIONAL REPORTING PERIOD In the event of and with effect from the retirement or ceasing to practice as a Registered Healthcare Practitioner in South Africa, the Insured, and in the event of death of the Insured, the Insured s executor on behalf of the Insured s Estate, is granted an additional period of sixty (60) months (hereinafter referred to as the Additional Reporting Period) to identify circumstances in connection with work performed during the currency of this Policy that may give rise to a claim for indemnity in terms of this Policy, or any HPCSA complaints, regardless of the nature thereof, and provided that:- Page 16 of 17 CFP & Hollard Scheme Medical Practitioner Wording 2015

17 a) the Additional Reporting Period i) is not granted should the Insured s license or right to practice have been revoked, suspended or surrendered or should any prior breach of this Policy by the Insured or by the Insured s executor have occurred; ii) iii) iv) is subject otherwise to all the terms, Exclusions and Conditions of this Policy; shall not apply to claims made against the Insured by reason of any indemnifiable circumstances prior to the commencement date of the Additional Reporting Period; shall, notwithstanding the stated sixty (60) months period, terminate immediately at the commencement date thereof should insurance be obtained by the Insured replacing in whole or in part the insurance afforded by this Policy. (This will not apply where The Insured obtains insurance in any country outside of South Africa to cover professional duties rendered in any country outside of South Africa); b) the Insurer s total liability in respect of all claims made during the final Period of Insurance and all circumstances identified during the Additional Reporting Period shall in no event exceed the Limit of Indemnity as stated in the Schedule which applied immediately prior to commencement of the Additional Reporting Period DEFAMATION Insurers may indemnify the Insured in respect of claims arising out of defamation by the Insured. The Insurers may elect not to indemnify the Insured where the circumstances of the alleged defamation lead them to believe that the Insured acted with malicious intention. The onus will be upon the Insured, if Insurers elect not to indemnify the Insured for this reason, to prove that they did not act with malicious intention BREACH OF CONFIDENTIALITY Insurers will indemnify the Insured in respect of claims first made against the Insured during the Period of Insurance arising out of: a) the actual or alleged breach of Protection of Personal Information Act 2013 as amended from time to time and regulations thereunder arising out of or in the course of Business provided that the Claim is notified to the Insurer during the Period of Insurance. b) Unintentional breach of trust or unintentional breach of patient confidentiality 12.4 COURT/INQUIRY ATTENDANCE COSTS This policy will reimburse the Insured up to R2,000 per day or part thereof that the Insured is required by Insurer s legal counsel to be in attendance at court, or required to be in attendance at an inquiry of the HPCSA, limited to a maximum of R10,000 per Insured policy period, for reasonable costs incurred with the prior written consent of the Insurers necessitated by the Insured s and/or their employees attendance at court or an inquest or inquiry or in respect of the Insured s loss of income as the result of attendance at court or an inquest or an inquiry. Page 17 of 17 CFP & Hollard Scheme Medical Practitioner Wording 2015